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Objective@#To analyze the clinical features and possible pathogenesis of sudden deafenss and vertigo induced by inner ear hemorrhage.@*Methods@#Clinical data of 30 patients with inner ear hemorrhage, from the first affiliated hospital of Sun Yat-sen university during Jan 2016 to May 2017, were retrospectively analyzed.@*Results@#Vergito and profound deafness were seen in all patients. The duration of vertigo ranged from 24 hours to three days in 11 cases, three to 14 days in the remaining 19 cases. Simultaneous occurrence of vergito and deafenss were seen in 24 patients. Semicircular canal hypofunction and abnormal cervical vestibular evoked myogenic potentials(C-VEMP)/ocular vestibular evoked myogenic potentials(O-VEMP) were detected in all cases. Ten patients had benign paroxysmal positional vertigo(BPPV) simultaneously. Hearing recovered in 20% of the cohort posttreatment. Dizziness and balance disturbance disappeared 1 to 2 months after therapy in 16 cases. Long term (6 months) follow up revealed poor hearing outcome and vestibular rehabilitation.@*Conclusion@#Vestibular vertigo and profound sensorineural hearing loss, with unsatisfactory clinical prognosis, constituted the characters of inner ear hemorrhage-associated sudden deafness.
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Objective To investigate the relationships between tinnitus masking curve types and tinnitus re-sidual inhibition in the patients at different ages with normal hearing ,mild ,moderate severe hearing loss .Methods The minimum masking levels and residual inhibition of 335 patients with normal hearing ,mild to medium ,and mod-erate to severe hearing loss were tested and analyzed using the method of psychological acoustics .Results Ages and the duration of residual inhibition had a corresponding relationship :the 19～30 years old group had corresponding relations with 0～40 seconds of residual inhibition ,while the 31～50 years old group with 81～100 seconds of resid-ual inhibition ,and the 50～63 years old group with 101～200 seconds of residual inhibition ,respectively .The 31～50 years old group and 51％ ～80％ residual inhibition had a corresponding relationship ;0％ ～30％ residual inhibi-tion group and parallel type of tinnitus masking curves had a corresponding relationship ,31％ ～50％ residual inhibi-tion group and separation type of the tinnitus masking curves had a corresponding relationship ,the groups of 51％ ～80％ and 81％ ～100％ residual inhibition with the types of convergent and overlapping tinnitus masking curves had corresponding relationship ,respectively .Conclusion There were different characteristics of tinnitus masking patients at different ages with different levels of hearing loss .The older people are ,the better effects and longer time of residual inhibition are .Those tinnitus patients with the tinnitus masking curve of convergent type and overlapping type showed a better tinnitus masking effect than the others .
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BACKGROUND: Auditory steady-state responses (ASSR) is an objective method of hearing examination in clinic in recent years. ASSR has the frequency specificity as compared with previous auditory brainstem responses (ABR).OBJECTIVE: To investigate the accuracy of ASSR in objective hearing assessment.DESIGN: A case-control observation.SETTING: Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University.PARTICIPANTS: The subjects in the normal hearing group were the 21 undergraduates (42 ears) were enrolled, they all had not any symptoms of ear disease, without history of noise exposure and disease of vestibule system, and they were normal in otoscopy. The outpatients and inpatients with neurosensory deafness were selected from the Department of Otorhinolaryngology, the First Affiliated Hospital of Sun Yat-sen University. All the children cases worn hearing aids, and had the speech ability, and cooperated in the examination. The main types included 6 ears of sudden deafness,8 ears of presbycusis, and 20 ears of neurosensory deafness due to other unknown causes. Central lesions were excluded by MR examination, and all the patients agreed with the enrollment. The results of pure-tone audiometry were all flat or descending audiogram. According to the severity of hearing damage, the patients were divided into mild deafness group (13ears), moderate deafness group (9 ears) and moderate-to-severe deafness group (12 ears).METHODS: ① The pure-tone audiometry was performed at the frequencies of 0.125-8 000 Hz in a sound insulation room. The auditory threshold grades of the subjects with normal hearing all accorded with the standards of GB-7583-87 expected value distribution. The average value of air-conduction auditory thresholds of pure-tone audiometry at the frequencies of 0.5, 1, 2 and 4 kHz was calculated. ② ASSR measurement was performed with the synchronous stimulation pattern in a sound and electromagnetic shielding room, including 8 points for both ears of the same stimulation intensity and the carrier frequency tones of 0.5, 1, 2 and 4 kHz respectively.③ ABR examination was performed by click sounds with sparse waves in a sound and electromagnetic shielding room, and insert earphones were used.The threshold results were judged according to the minimal stimulation sound intensity of the distinguishable Ⅴ wave. ③ The results of pure-tone audiometry were compared with those of ABR examination, and the results of ASSR measurement in different hearing groups were processed with analysis of variance, multi-classification discrimination based Bayes standard and q test.MAIN OUTCOME MEASURES: The thresholds of pure-tone audiometry, ASSR measurement and ABR examination, and the correct rate analyzed by the multi-classification discrimination based Bayes standard were mainly observed.RESULTS: The indexes of the 42 ears in the normal hearing group, 13, 9 and 12 ears in the mild, moderate and moderate-to-severe deafness groups were all involved in the analysis of results. ① The ABR values were accorded with the actual hearing levels, and the closest to the ASSR thresholds at 1-2 kHz; ASSR reflected induction rates at different frequencies were gradually decreased with the aggravation of hearing damage, and that at each frequency varied with the changes of hearing level, the induction rates of ASSR responses were all 100% for the subjects with normal hearing and patients with mild deafness, but those for the patients with moderate and moderate-to-severe deafness were decreased (0.5 kHz: 77.8%,92.8%; 4 kHz: 88.9%, 85.7%). At different frequencies, the ASSR thresholds in the moderate-to-severe deafness group were significantly higher than those in the normal hearing group (P ＜ 0.05). The ASSR thresholds at 0.5 and 4 kHz in the moderate-to-severe deafness group were significantly higher than those in the mild deafness group (P ＜ 0.05). The ASSR threshold at 2 kHz in the mild deafness group was significantly higher than that in the normal hearing group (P ＜ 0.05). The ASSR thresholds at 4 kHz in the everedeafness group were significantly higher than those in the normal hearing group and mild deafness group. ② The incorrect discriminations of actual pure-tone audiometry were analyzed with the interactive clustering discriminant analysis of ASSR measurement and actual pure-tone audiometry, and the results showed that the correct rate of discrimination was 100% in the normal hearing group; Only 1 of the 12 cases in the mild deafness group was incorrectly judged, and the correct rate was 92%; Only 1 of the 19 cases in the moderate deafness group was incorrectly judged, and the correct rate was 89%; the correct rate in the moderateto-severe deafness group was 83%.CONCLUSION: The results of ASSR measurement can detect the incorrect discrimination of objective hearing condition by taking the results of pure-tone audiometry as the standards. ASSR has an acceptable accuracy for deafness higher than mild level in estimating objective hearing, and it has a better prospect of application in practice.
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Objective To explore the advantages of intraoperative NRT measurement(neural response telemetry)during cochlea implant surgery.Methods Intraoperative and postoperative NRT measurements were tested in ten SNHL children with CI24M-Nucleus and four SNHL children with CI24R(CS)-Nucleus, the ECAP threshold of intraoperative and postoperative measurements were compared, and the first maps were set up according to the intraoperative ECAP threshold.Results The average intraoperative ECAP threshold of 22 electrodes was higher than postoperative ECAP threshold, the average intraoperative ECAP threshold of CI24M-Nucleus' 22 electrodes was 11CL greater than postoperative ECAP threshold. It was just five minutes to record ECAP of 10 electrodes, and the beginning of fitting was finished in one hour.Conclusion It is confirmed that intraoperative NRT measurement could test the integrity of implants, and could estimate the first map. It is convenient to use and should be popularized.
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Objective To explore the changes of the peak pressure of tympanogrom in the first year before and after radiotherapy for Nasopharyngeal Carcinoma (NPC) and observe its effect to audition.Methods Acoustic immittance and audiometry were used to detect 64 ears of NPC patients at regular intervals (before, during,at the end of rediotherapy and 6,12 months after radiotherapy). The data were collected and analyzed with statistic methods. Results There were 9 ears with secretory otitis media after radiotherapy. The peak pressure of tympanogrom of other 55 ears was negative at the beginning of radiation, reached highest at the end of radiotherapy,the average was -30(-100, 5.0) daPa.Compared with the peak pressure of tympanogrom before radiation, there was significant statistic difference ( P =0.001). The peak pressure reached to the level of pre-radiation 12 months after radiation, 5.0(-2.5,10.0) daPa. The 2.0 kHz audiometric threshold of bone conduction was 21.4?5.7 dB in 55 ears, compared with the audiometric threshold before radiation, there was evident statistic difference (P